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HomeMy WebLinkAboutPW14-070 - Amendment - #1 - Hough Beck & Baird Inc. - S 212th St. Grade Seperation - 12/18/2014 iy r , rt k , Recordsanee 6fiY'i.1 x�n ;" KENT � Document Wa= o CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Hough Beck & Baird, Inc. Vendor Number: JD Edwards Number I Contract Number: [i ';i I'H- Gf -1 00 This is assigned by City Clerk's Office Project Name: S. 212th St. Grade Separation Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/18/14 Termination Date: 12/31/15 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Mark Madfai Department: Engineering Contract Amount: Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to December 31, 2015 in case services are needed for funding applications or LID. As of: 08/27/14 KENT AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Hough Beck & Baird Inc. CONTRACT NAME & PROJECT NUMBER: S. 212th St. Grade Separation ORIGINAL AGREEMENT DATE: March 27, 2014 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: The scope of work remains the same, however an amendment is needed to extend the time of completion to December 31, 2015. Additional time is necessary in case services are needed for funding applications or LID. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, $7,600.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $7,600.00 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $7,600.00 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/14 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'I Days Required {t) for this 365 calendar days Amendment Revised Time for Completion 12/31/15 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VE DOR: CITY � NT: I By: By:- `a a,r si a ur (s nature) Print Name: Print Name: Timothy J. LaPorte, P.E. Its Its Public Works Director ( le) (ti ) DATE:_ DATE'�r 2- APPROVED AS TO FORM: (applicable if Mayor's signature required) I Kent Law Department Nough Neck BaIM-212"Photo Simulations Amid 1JMadfai AMENDMENT - 2 OF 2 F-DATE AC<>R& CERTIFICATE OF LIABILITY INSURANCE 4/16/20114} PRODUCER (206) 621-6444 FAX: (206)515-0560 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION r—rry and Rogers Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 0 5th Ave. #1825 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Seattle WA 98101 INSURERS AFFORDING COVERAGE NAIC# -- ----- -._.. _... INSURED _...... ____..__ I_INsuRER A.TRAVELERS INDEMNITY CO HOUGH BECK & BAIRD, INC INSURER B:TRAVELERS PROPERTY CASUALTY 215 WESTLAKE AVE NORTH INSURER aTRAVELERS CASUALTY & SURETY INSURER P. SEATTLE I WA 98109 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OFSUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ _ - _ INSR OD' POLICY EFFECTIVE POLICY EXPIRATION LIMITS T y POLICYNUMBER DATE tMWDDffYYYJ DATE GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY -PREMISES.(Eg QeceTYnce) $ 300,000 A X CLAIMS MADE 1XI OCCUR'16809CS38779 5/16/2014 5/16/2015 MEDEXPAn onepereon) $ 51000 PERSONAL&ADV INJURY $ 11 000 000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPJOP AGG It 2,000,000 POLICY X PECT RO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 B X ALL OWNED AUTOS BA9CS55322 5/16/2014 5/16/2015 BODILY INJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS ',., BODILY INJURY - �' X NOWOWNED AUTOS (Per accident) I$ ---.. PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGO $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 2,00 X OCCUR CLAIMS MADE AGGREGATE $ 2,000,000 $ _ B X DEDUCTIBLE CUP9C555555 5/16/2014 5/16/2015 $ X RETENTION $ 51 000, $ WORKERS COMPENSATION WC STATU- X OTH- AND PROP lIETORIPARTNITY : 5/16/2014 5/16/2015 E.L.EACH ACCIDENT _($ 11000,000_ ANY PROPRIETOR/PARTNERlEXECUTIVE I6809C538779 If yes, OFFIOEPoMEM6ER EXCLUDED A (Mandatory in NH) - - E.L.DISEASE-EA EMPLOYE $ 1,000,000 e under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 11000,000 C OTHER PROFESSIONAL 105277406 5/16/2014 5/16/203.5 Each Claim $1,000,000 LIABILITY Annual Aggregate $2,000,000 � I DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED SY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS ADDITIONAL INSURED AS RESPECTS THE OPERATIONS OF THE NAMED INSURED. Project: South 212th Street Grade Separation Projects. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EXPIRATION.. City Of Kent Engineering DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 1 Attn: Nancy YOshitake 400 West Gowe NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL '.. Kent, WA 98032 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Kari DiJulio/KD ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(zoogm) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 16809C538779 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of Kent 1 (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED(Section 11) Is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of"your work"for that insured by or for you. CG 20 10 1185 Copyright, Insurance Services Office, Inc., 1982 i CHANGE EFFECTIVE DATE:03-24-14 TRAVELERS J~ One Tower square, Hartford, Connecticut 06183 CHANGE ENDORSEMENT Named Insured: HOUGH BECK & BAIRD, INC. Policy Number: BA-9C555322-13-GRP Policy Effective Date: 05/16/13 Issue Date: 03/25/14 Additional Premium $ 23 INSURING COMPANY: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, Effective from 03/24/14 at the time of day the policy becomes effective. THIS INSURANCE IS AMENDED AS FOLLOWS: THE COMMERCIAL AUTOMOBILE COVERAGE PART IS AMENDED AS FOLLOWS: SAP EXTENSION COVERAGE IS ADDED. THE FOLLOWING FORM(S) AND/OR ENDORSEMENTS) IS/ARE ADDED TO THE POLICY AS PER FORM(S) ATTACHED: CA T3 53 03 10 NAME AND ADDRESS OF AGENT OR BROKER: COUNTERSIGNED BY: GURRY & ROGERS INSURANCE (DCD88) 1200 STH AVE STE 1825 / SEATTLE, WA 98101 Authorized MpresentatiV IL TO 07 09 87 PAGE 1 OF 1 DATE: OFFICE: RETAIL A&E CHANGE EFFECTIVE DATE:03-24-14 TRAVELERSJ� POLICY NUMBER: BA-9C555322-13-GRP EFFECTIVE DATE: 05-16-13 ISSUE DATE: 03-25-14 LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS. IL TO 07 09 87 CHANGE ENDORSEMENT IL T8 01 10 93 FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS COMMERCIAL AUTOMOBILE CA T3 53 03 10 BUSINESS AUTO EXTENSION ENDORSEMENT i i i i I IL T8 01 10 93 PAGE: 1 OF 1 CHANGE EFFECTIVE DATE:03-24-14 OVERPRINT/CHANGE SLIP PAGE 1 OF I POLICY NUMBER: BA-9C555322-13-GRP RATER: MPSG ISSUE DATE: 03/25/14 ARCHITECTS EFFECTIVE DATE: 05/16/13 EXPIRATION DATE: 05/16/14 CHANGE EFFECTIVE DATE: 03/24/14 INSUREDS NAME: HOUGH BECK & BAIRD, INC. PRORATA FACTOR: 0.145 SHORT RATE FACTOR: NEW/RENEWAL: N PAYMODE: B SOLICITOR CODE: AUDIT FREQUENCY: N SAI: 7438PA175 RESPONSIBILITY: X MSI: WATCH FILE: W RATING MODE: G SURVEY CODE; 2 SPECIAL CODE: REINSURANCE: N PROGRAM CODE: B13 AUTO FILINGS: N - FEDERAL TAX ID: PREMIUM SUMMARY ACCOUNT EFF. NON S.B. MONTH DATE PREMIUM PREMIUM TOTAL D 23.00 0.00 23.00 TOTAL: 23.00 0.00 23.00 OFFICE: RETAIL A&E 21W PRODUCER NAME: GURRY & ROGERS INSURANCE DCD88 it CHANGE EFFECTIVE DATE:03.24-04 TRAVELERSAIJ PREMIUM SPLIT FORM PAGE 1 OF 1 '... POLICY NUMBER: EA-9CS55322-13-GRP RATER: MP5G ISSUE DATE: 03/25/14 COMM ITEM COMM ITEM COMM ITEM COMM ITEM .1500 PREM ACCOUNT EFFECTIVE MONTH DATE PREMIUM PREMIUM PREMIUM PREMIUM 23 i i I OFFICE: RETAIL A&E 21W PRODUCER NAME: GURRY & ROGERS INSURANCE DCD88 ',.. i I I� Policy# BA9C555322 COMMERCIALAUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any Injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, dudes, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE—INCREASED LIMIT B. BLANKET ADDITIONAL INSURED 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT C. EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS E. SUPPLEMENTARY PAYMENTS — INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS OR LOSS F. HIRED AUTO — LIMITED WORLDWIDE M. BLANKET WAIVER OF SUBROGATION COVERAGE—INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED executed by you before the "bodily injury" or The "property damage" occurs and that is in effect he following is added to Paragraph A.1., Who I An Insured, of SECTION Il — LIABILITY COV- during the policy period, to be named as an addi- ERAGE: tional insured is an "insured" for Liability Cover- age, but only for damages to which this Insurance Any organization you newly acquire or form dur- applies and only to the extent that person or or- ing the policy period over which you maintain ganization qualifies as an "insured" under the 50% or more ownership interest and that is not Who Is An Insured provision contained in Section separately insured for Business Auto Coverage. It. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- 1. The following is added to Paragraph A.1., ever is earlier. Who Is An Insured, of SECTION 11 — LI- B. BLANKET ADDITIONAL INSURED ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION Il —LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 03 10 02010 The Travelers Indemnity Company. Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc.Mth its permission, COMMERCIAL AUTO 2. The following replaces Paragraph b, in B.5., within such country or jurisdiction, for Liability Other Insurance, of SECTION IV — BUSI- Coverage for any covered "auto" that you NESS AUTO CONDITIONS: lease, hire, rent or borrow without a driver for b. For Hired Auto Physical Damage Cover- a period of 30 days or less and that is not an age, the following are deemed to be cov- auto" you lease, hire, rent or borrow from ered "autos"you own: any of your"employees", partners (if you are a partnership), members (if you are a limited (1) Any covered "auto" you lease, hire, liability company) or members of their house- rent or borrow;and holds. (2) Any covered "auto" hired or rented by (a) With respect to any claim made or "suit" your "employee" under a contract in brought outside the United States of that individual "employee's" name, America, the territories and possessions with your permission, while perform- of the United States of America, Puerto ing duties related to the conduct of Rico and Canada: your business. However, an "auto"that is leased, hired, (i) You must arrange to defend the "in- However, sured"against, and investigate or set- rented or borrowed with a driver is not a tle any such claim or "suit" and keep covered"auto". us advised of all proceedings and ac- D. EMPLOYEES AS INSURED tlons. The following Is added to Paragraph A.1., Who Is (11) Neither you nor any other Involved An Insured, of SECTION 11 — LIABILITY COV- "Insured" will make any settlement ERAGE: without our consent. Any"employee" of yours Is an "insured"while us- (!it)We may,at our discretion, participate Ing a covered "auto"you don't own,hire or borrow in defending the "insured"against, or in your business or your personal affairs. In the settlement of, any claim or E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS (Iv)We will reimburse the "insured" for 1. The following replaces Paragraph A.2.a.(2), sums that the "insured" legally must of SECTION 11—LIABILITY COVERAGE: pay as damages because of bodily Injury" or"property damage" to which (2) Up to $3,000 for cost of bail bands (in- this Insurance applies, that the "in- cluding bonds for related traffic law viola- sured" pays with our consent, but Cons) required because of an "accident" only up to the limit described in Para- we cover. We do not have to furnish graph C., Limit Of Insurance, of SEC- these bonds. TION 11—LIABILITY COVERAGE. 2. The following replaces Paragraph A.2.a.(4), (v) We will reimburse the "insured" for of SECTION II—LIABILITY COVERAGE: the reasonable expenses incurred (4) All reasonable expenses incurred by the with our consent for your Investiga- "insured" at our request, including actual tion of such claims and your defense loss of earnings up to $500 a day be- of the "insured" against any such cause of time off from work. "suit", but only up to and included F. HIRED AUTO — LIMITED WORLDWIDE COV- within the limit described In Para- graph C., Limit Insurance, of SECTION 11 — LIABILITY COVER- The following replaces Subparagraph (5) In Para- AGE, and not in addition to such limit. graph B.7., Policy Period, Coverage Territory, Our duty to make such payments of SECTION IV — BUSINESS AUTO CONDI- ends when we have used up the ap- TIONS: plicable limit of Insurance in pay- (5) Anywhere in the world, except any country or ments for damages, settlements or Jurisdiction while any trade sanction, em- defense expenses. bargo, or similar regulation Imposed by the (b) This insurance is excess over any valid United States of America applies to and pro- and collectible other insurance available hibits the transaction of business with or i Page 2 of 4 ©2010 The Travelers Indemnity Company. CA T3 53 03 10 Includes copyrighted material of Insurance services Office,Inc.with Its permission. I COMMERCIAL AUTO to the "insured" whether primary, excess J. PERSONAL EFFECTS contingent or on any other basis. The following is added to Paragraph A.4., Cover- (c) This Insurance is not a substitute for re- age Extensions, of SECTION III — PHYSICAL quired or compulsory insurance In any DAMAGE COVERAGE: country outside the United States, Its ter- personal Effects ritories and possessions, Puerto Rica and Canada. We will pay up to $400 for "loss" to wearing ap- You agree to maintain all required or parel and other personal effects which are: compulsory insurance in any such coun- (1) Owned by an"insured";and try up to the minimum limits required by (2) In or on your covered "auto". local law. Your failure to comply with This coverage applies only in the event of a total compulsory insurance requirements will theft of your covered"auto". not invalidate the coverage afforded by this policy, but we will only be liable to the No deductibles apply to this Personal Effects same extent we would have been liable coverage. had you complied with the compulsory in- K. AIRBAGS surance requirements. The following is added to Paragraph B.3., Exclu- (d) It is understood that we are not an admit- sions, of SECTION III — PHYSICAL DAMAGE ted or authorized insurer outside the COVERAGE: United States of America, its territories Exclusion 3.a. does not apply to "loss" to one or and possessions, Puerto Rico and Can- more airbags in a covered "auto"you own that in- ada. We assume no responsibility for the flate due to a cause other than a cause of"loss" furnishing of certificates of insurance, or set forth in Paragraphs A.1.b. and A.1.c., but for compliance in any way with the laws only: of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE—GLASS a. if that "auto" is a covered "auto"for Compre hensive Coverage under this policy; The following is added to Paragraph D., Deducti- b. The airbags are not covered under any war- ble, of SECTION III — PHYSICAL DAMAGE ranty;and COVERAGE: No deductible for a covered "auto" will apply to c. The airbags were not intentionally inflated. glass damage if the glass is repaired rather than We will pay up to a maximum of $1,000 for any replaced. one"loss". H. HIRED AUTO PHYSICAL DAMAGE—LOSS OF L. NOTICE AND KNOWLEDGE OF ACCIDENT OR USE—INCREASED LIMIT LOSS The following replaces the last sentence of Para- The following is added to Paragraph A.2.a., of graph AA.b., Loss Of Use Expenses, of SEC- SECTION IV—BUSINESS AUTO CONDITIONS: TION III—PHYSICAL DAMAGE COVERAGE: Your duty to give us or our authorized representa- However, the most we will pay for any expenses tive prompt notice of the "accident" or "loss" ap- for loss of use is $65 per day, to a maximum of plies only when the "accident" or"loss" is known $750 for any one"accident". to: I. PHYSICAL DAMAGE — TRANSPORTATION (a) You (if you are an individual); EXPENSES—INCREASED LIMIT (b) A partner(if you are a partnership); The following replaces the first sentence in Para- (c) A member (if you are a limited liability com- graph AA.a., Transportation Expenses, of pany); SECTION III — PHYSICAL DAMAGE COVER- (d) An executive officer, director or insurance AGE: manager (if you are a corporation or other or- We will pay up to $50 per day to a maximum of ganization);or $1,500 for temporary transportation expense in- (e) Any "employee" authorized by you to give no- curred by you because of the total theft of a cov- tice of the"accident"or"loss". ered "auto"of the private passenger type. CA T3 53 03 10 C 2010 The Travelers Indemnity Company. Page 3 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION such contract. The waiver applies only to the The following replaces Paragraph A.S., Transfer person or organization designated in such Of Rights Of Recovery Against Others To Us, contract. of SECTION IV — BUSINESS AUTO CONDI- N. UNINTENTIONAL ERRORS OR OMISSIONS TIONS: The following is added to Paragraph B.2., Con- S. Transfer Of Rights Of Recovery Against cealment, Misrepresentation, Or Fraud, of Others To Us SECTION IV—BUSINESS AUTO CONDITIONS: We waive any right of recovery we may have The unintentional omission of, or unintentional against any person or organization to the ex- error In, any Information given by you shall not tent required of you by a written contract prejudice your rights under this insurance. How- signed and executed prior to any "accident' ever this provision does not affect our right to col- or"loss", provided that the"accident'or"loss" fact additional premium or exercise our right of arises out of operations contemplated by cancellation or non-renewal. i Page 4 of 4 O 2010 The Travelers Indemnity Company. CA T3 53 03 10 Includes copyrighted material of Insurance Services office,Inc.with Its permission.